Gendered Situated Vulnerabilities and Mental Health among Transgender Men in India

项目摘要 跨性别者健康研究历来专注于跨性别者女性，但在有数据的情况下， 变性人和变性人(TM)表现出相似或更高的心理健康负担。处于低位 然而，在中等收入国家，TM人群的心理健康状况几乎完全没有得到研究。一个 2019年系统审查显示，印度没有关于TM心理健康的科学出版物，这个国家 占全球精神障碍负担的15%，变性人社区 经历可能影响心理健康的重大社会法律变化。为了填补这一关键空白，混合- 方法对TM心理健康进行研究，包括在南亚首次对TM进行定量调查。 本研究提出了一种新的跨男性性别化情境漏洞框架，该框架集成了 基于性别的分析，从少数群体压力的角度来理解 与性别认同和分配的性别有关的脆弱性和复原力，位于印第安人 社会文化背景。应用以社区为基础的参与性研究方法和顺序(QUAL Quant)混合方法设计，30个TM将接受定性采访(德里15个，孟买15个， 印度最大的城市)和300个TM(每个城市150个)将被招募到一项量化调查中，使用在线和In- 有人接近了。具体目标是： 1.使用定性方法，确定印度人经历的按性别划分的脆弱性和复原力 TM，并探索感知的心理健康影响和干预建议。 2.制定、调整和心理测量评估脆弱程度(例如，家庭排斥和暴力) 和恢复力(例如，社区联系、家庭接受)，对于印度TM。 3.量化印度TM和TM的心理健康挑战(抑郁、焦虑、自我伤害、自杀) 评估与基于性别的脆弱性和多层次复原力之间的关联。 为了为未来对这一人群的研究和干预提供信息，还将使用调查数据来比较 在线招聘策略与面对面招聘策略的有效性。这一及时研究的意义在于 在印度TM人群中识别与心理健康相关的多水平因素，具有潜在的影响 印度及其他地区迅速演变的变性人健康和社会政策。这项拟议的研究适用于 创新的理论框架，“让性别回归变性人的健康”。预期结果包括 开发反映TM家庭经验的新措施，并在全球和美国进行应用。 变性人健康研究。研究结果将为制定和评估干预措施提供信息 在印度促进TM的心理健康(R34/R01)。

Project Summary Transgender health research has historically focused on transgender women, yet where data are available, transgender men and transmasculine persons (TM) demonstrate similar or higher mental health burden. In low and middle-income countries, however, mental health among TM remains almost entirely unresearched. A 2019 systematic review revealed no scientific publications on TM mental health in India, a country that accounts for 15% of the global burden of mental disorders and where the transgender community is experiencing major socio-legal changes that may impact mental health. To fill this critical gap, a mixed- methods study of TM mental health is proposed, including the first quantitative survey of TM in South Asia. This study introduces a novel Transmasculine Gendered Situated Vulnerabilities framework which integrates gender-based analysis with a minority stress perspective to understand the mental health effects of vulnerabilities and resiliencies related to gender identity as well as assigned sex, situated within the Indian socio-cultural context. Applying a community-based participatory research approach and a sequential (QUAL  QUANT) mixed-methods design, 30 TM will be qualitatively interviewed (15 in Delhi and 15 in Mumbai, India's largest cities) and 300 TM (150 per city) will be recruited to a quantitative survey using online and in- person approaches. The specific aims are to: 1. Using qualitative methods, identify gendered situated vulnerabilities and resiliencies experienced by Indian TM and explore perceived mental health impacts and recommendations for interventions. 2. Develop, adapt, and psychometrically assess measures of vulnerabilities (e.g., family rejection and violence) and resiliencies (e.g., community connectedness, family acceptance), for Indian TM. 3. Quantify mental health challenges (depression, anxiety, self-injury, suicidality) among Indian TM and evaluate associations with gendered situated vulnerabilities and multi-level resiliencies. To inform future research and interventions with this population, survey data will also be used to compare the effectiveness of online versus in-person recruitment strategies. The significance of this timely study lies in the identification of multi-level factors associated with mental health among Indian TM, with the potential to impact rapidly evolving transgender health and social policies in India and beyond. The proposed research applies an innovative theoretical framework to “put the gender back into transgender health”. Expected outcomes include the development of new measures reflecting family experiences of TM, with applications for global and U.S. transgender health research. Study results will inform the development and evaluation of an intervention to promote mental health for TM in India (R34/R01).